Cone biopsy

A cone biopsy is another procedure to remove abnormal cervical tissue. You may also hear it called "conization" or "cold knife biopsy."

How does your doctor decide which surgery to do: LEEP v. cone?

For this procedure, you are under anesthesia typically. Before they put you under anesthesia, they will have you climb up and lie down on the surgical table, putting your feet in stirrups, just like for a Pap smear. Once you are asleep, the doctor takes a cold knife and cuts out a cone-shaped segment of the lower cervix. This is a more precise surgery than the LEEP. The surgeon has to put in stitches to seal up the incision, and so you may have some bleeding afterward. It should not be a lot of bleeding, though.

After surgery, you'll stay in recovery for an hour or two, and then you'll go home. Generally, they say not to have sex or use tampons for at least 2 weeks because putting anything in your vagina could cause an infection while your cervix is still healing.

You don't have to go back to have the stitches removed because they'll dissolve on their own. I found the recovery from cone biopsy to be better than LEEP because I didn't have the brown discharge like I did with LEEP.

The doctor will send the tissue to the pathology lab (click on the link to learn more about who reads Pap smears and lab tissue) to examine it and make sure that the edges (or margins) of the tissue are free of cancer. If the tissue edges are clear, then you'll just have to go for more frequent Pap smears, like every 4 months.

These are some things that can happen after surgery:

Doctors like for you to wait at least 6 months, preferably a year, before trying to conceive. Your cervix needs time to heal. They also want to be sure the cancer doesn't come back.

While the procedure removes part of your cervix, even if you have more than one procedure, you should still be able to have a vaginal delivery. You will have scarring of your cervix, but that should not be a big obstacle to labor and delivery. I talk more about the scarring under cervical stenosis.